Panel to study Mississippi mental health system

Published 1:13 pm Tuesday, April 28, 2009

For many Mississippians with mental illness, the condition initially manifests itself in ways that could be treated without inpatient care.

The problem is that patients do not get into community-based programs after the onset of early symptoms and the illness grows worse, eventually leading to a stay in the hospital or some other treatment facility.

That “disconnect” is what Department of Mental Health Director Ed Legrand hopes a new study committee will address once it begins meeting this year. Legislation signed by Gov. Haley Barbour creates a joint legislative panel to study and make recommendations for improving the delivery of mental health services in the state.

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Legrand, who has been asking for the legislation for a couple of years, said it will clarify the roles and responsibilities of the different components of the system, including his agency, community mental health centers and private facilities.

Legrand said he’s hopeful the committee will encourage a revision in state laws to “change the delivery of services to a community-based system rather than continue to rely on inpatient.”

More than 100,000 people are served in community mental health centers each year. Legrand said less than 20 percent served by those centers required hospitalization.

“It’s about raising awareness, removing the stigma associated with mental illness, and providing additional resources for mental treatment, including suicide prevention,” Legrand said. “We just need to shore up and have a stronger collaboration with other community health centers and mental health providers.”

The Performance Evaluation and Expenditure Review Committee, a legislative watchdog group, issued a report last year that said the Department of Mental Health should begin long-range planning to offer more community-based services as alternatives to hospitalization.

Inpatient services cost $436.2 million, an average of $314.44 a day, in the fiscal year that ended July 1, 2008. Legrand said while community-based services may not always be cheaper, they are more cost-effective.

“It allows you to provide services to more people and spread your dollar further,” he said.

The PEER report was only part of the motivation for the legislative action, said House Public Health Committee Chairman Steve Holland, a Democrat from Plantersville.

“Nobody is down on the system. We just think we’ve got a major disconnect between institutions and services. We think we need to put as many people as we can in their home communities,” Holland said. “We’re going to make this the number one public health issue over the next year.”

Mental illness runs the gamut from schizophrenia, as depicted in the new movie “The Soloist” to drug addiction, depression and personality disorders.

“Even though mental health is fairly prevalent, most people don’t know what to do when somebody they love gets sick. One of the problems is a lack of literacy,” said Debbie Holt, executive director of the Mental Health Association of the Capital Area, a group of concerned citizens who promote mental health care.

Maurice Kahlmus, executive director for Weems Mental Health in Meridian, said this will be the first time the state has conducted a comprehensive study on the system. It’s a move he believes is needed as more people are being diagnosed with mental illness.

Kahlmus said his outpatient facility had more than 10,000 active cases in 2008, a 10 percent increase over the previous year.

“In a poor state like Mississippi, we need to be sure the dollars that are being spent can benefit the patients with the greatest needs,” Kahlmus said. “We’re mandated to serve everybody that comes through our door, regardless of what they can pay. A large number pay nothing or very little.”

The bill is House Bill 897.